Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

But Alice Nyambai of Homa Bay District AIDS coordinator's office, while approving of the operation for minors, also highlights a need for swabs, surgical spirits, latex gloves and Jik (a brand of bleach). This comment corroborates findings that supplies used in infection control in health facilities in Kenya (and other African countries) are poor. Just how safe are conditions in facilities that are trying to handle thousands of circumcision operations when they are often unable to cope with routine health provision?

Nyambai points out that circumcision in children and infants can be cheaper than for adults, citing a $60 figure for the latter and a $12 figure for the former group (though, as the $60 dollar figure doesn't include all the costs, the $12 figure probably doesn't either). But does the fact that the operation is cheaper make it any more justifiable, under the circumstances? The cost of more vital and cost-effective procedures is far lower, but those costs are frequently not met, with the number of children and infants dying of treatable and preventable illness running into tens of thousands every year.

HIV prevalence in parts of Nyanza province is high among the Luo people, among whom circumcision rates are also low. But the same research that purported to show that circumcision reduces the risk of transmission from females to males also showed that it may not be the lack of circumcision that increases HIV transmission risk, but something else entirely. Which makes one wonder why circumcision enthusiasts were so cavalier about having no idea what mechanism might be involved in the claimed protective effect of circumcision.

Circumcision proponents continue to ignore their own evidence about a cheap, safe and effective strategy for reducing HIV transmission: penile hygiene. Indeed, they continue to withhold some of the data they themselves collected. Instead, plans to circumcise tens of millions of adults, and probably similar numbers of children and infants, are to go ahead This is all costing billions of dollars that would save far more lives if spent on genuine priorities, with all the well-documented risks involved in rolling out such a program. It sounds as if these public health 'experts' are not answerable to the people they claim to be serving.